Which Type of Estrogen Hormone Therapy Is Right for You?
Even after you’ve decided to take estrogen replacement therapy (ERT), the decision-making isn’t over. There are many types of estrogen therapy in many different forms — pills, patches, suppositories, and more. The best type of hormone replacement therapy (HRT) depends on your health, your symptoms, personal preference, and what you need to get out of treatment. For example, if you still have your uterus, then estrogen will be given in combination with the hormone progestin.
Oral medication is the most common form of ERT. Examples are conjugated Estrogens (Premarin), estradiol (Estrace), and Estratab. Follow your doctor’s instructions for dosing. Most estrogen pills are taken once a day without food. Some have more complicated dosing schedules.
Pros. Like other types of estrogen therapy, estrogen pills can reduce or resolve troublesome symptoms of menopause. They can also lower the risk of osteoporosis. While there are newer ways of getting ERT, oral estrogen medicines are the best-studied type of estrogen therapy.
Cons. The risks of this type of estrogen therapy have been well-publicized. On its own, estrogen causes a slight increase in the risk of strokes, blood clots, and other problems. When combined with the hormone progestin, the risks of breast cancer and heart attack may rise as well. Oral estrogen — like any estrogen therapy — can also cause side effects. These include painful and swollen breasts, vaginal discharge, headache, and nausea.
Because oral estrogen can be hard on the liver, people with liver damage should not take it. Instead, they should choose a different way of getting estrogen.
Estrogen is also sometimes not well absorbed, especially if you take certain medicines or have stomach problems. It may also increase your cholesterol, because it is metabolized in the liver.